Editorial | Vaccinations and the Anti-Vaxxers

S.A. Shepler (c) 2019 Community Word“Vaccine refusal is like a big pile of tinder waiting for a lightning strike.”

Dispute resolution is foundational to civil society. Whether that means speed limits on the roads, individual gun rights or mandatory vaccinations –– individual versus societal rights must be systematically addressed and equitably balanced. Often that is through debate and regulation.

When resolution does not evolve from systematic analysis, the conflict often falls into the cauldron of public speculation and fear mongering over the Internet.

That’s what’s happened with vaccinations. Vaccines are safe, effective and boring. “The Greatest Story Never Told” is how one website refers to vaccine safety.

To assess the anti-vaccination fear, it helps to start with the assumption all parents love their children and want to protect them.

Moving forward with the analysis:

Measles is a serious disease that was on the verge of elimination before anti-vaccination fear started undermining medical research and science. There have been seven cases of measles in Illinois so far this year compared with five last year. No cases have been reported in Peoria County, according to Kathryn Endress, Peoria City/County Health Department director of epidemiology and clinical services.

Diagnosed cases of measles are increasing globally, yet there are very few reasons not to get vaccinated, Endress said, noting that vaccines have been studied extensively and are safe.

Children who medically cannot receive vaccinations are put at increased risk by children who are not vaccinated due to “vaccine hesitation.”

About 13,000 students are enrolled in Peoria Public Schools and 181 students have not been vaccinated. Of those, 100 cannot receive vaccinations due to medical reasons and 81 others have received exemptions, said Thomas Bruch, district spokesman.

Outbreaks of measles in New York State have climbed to the hundreds, and New York State lawmakers are so alarmed they are considering to eliminate religious exemptions for vaccinations. California did that after an outbreak. In Michigan, those requiring to opt out of vaccinations must schedule a consultation with the local health department.

Measles is not a benign childhood disease. Complications can be hearing loss, pneumonia, encephalitis (swelling of the brain) causing convulsions and permanent mental disabilities. For every 1,000 children who get measles, one or two die from the disease. Infants and toddlers too young to receive vaccinations are at increased risk, as are pregnant women.

The debate is between those who contend vaccinations should be mandatory for the safety of society as a whole, a notion opposed by those who contend refusal is a basic individual right in a democratic society.

There was a fascinating discussion recently following the grand rounds lecture about vaccinations and anti-vaxxers by Dr. Gary Marshall at the Jump Trading Simulation and Education Center.

How do medical practitioners handle anti-vaxxers among their patients?

One pediatrician in the audience said she would retain the patient but take every opportunity to inform the parents that vaccinations are scientifically-proven to be safe and effective.

Another said she would help the parents find another doctor for their child rather than expose her other patients to disease.

Marshall, chief of the division of pediatric infectious diseases and professor of pediatrics at the University of Louisville School of Medicine, delivered the annual Hart Endowed Lecture at the University of Illinois College of Medicine at Peoria. He said science clearly comes down on the side of vaccinations.

People who refuse the flu shot often cite the statistic that it is only 30 percent effective in preventing flu. But that is not the correct measurement, Marshall contends. The flu shot is extremely effective in preventing hospitalizations and death from the flu. Those who contract the flu despite the vaccination usually have a dramatically milder illness than had they forgone vaccination.

He said misinformation is similarly clouding public assessment of the chickenpox vaccination. It is not linked to autism. That was the false contention of one scientist. His study was later withdrawn, and he has been widely discredited.

“Vaccination hesitancy means that two decades after measles was virtually eliminated, cases are now on the rise,” Marshall said.

The vaccine against the human papilloma virus that causes cervical cancer is almost 100 percent effective, Marshall said. Australia has set a target of 2030 to eliminate cervical cancer. Yet almost half of parents in the United States still refuse the HPV vaccine to protect their children.

Marshall ticked off a list of devastating diseases virtually eliminated by vaccination: smallpox, type II polio, endemic measles, rubella.

“Yes, we still have cases of rubella, but it is not spreading to entire communities. We are seeing cases because some parents refuse to give the vaccine,” Marshall said.

“Vaccine refusal is like a big pile of tinder waiting for a lightning strike.”

Marshall is alarmed that three-fourths of young pediatricians have indicated they are willing to go along with parents who do not want to follow the vaccination schedule established by the Centers for Disease Control and Prevention but want to follow their own, alternative schedule.

Rather than following the doctor’s orders, young physicians are more willing to partner with parents in decision making.

“That makes the medical provider seem wishy-washy,” he said. “We don’t do that with our auto mechanics. But in medicine, we have relinquished authority to Jenny McCarthy.”

McCarthy is a former Playboy magazine “playmate of the month,” an actress and anti-vaxx blogger with no academic scientific training who has stoked nationwide fear about vaccinations and linked them to autism.

The World Health Organization calls “vaccine hesitancy” as one of the 10 greatest threats to human health.

Spreading out the CDC vaccination schedule by using an alternative schedule spreads out vulnerability to disease, Marshall said.

Parents are finding so-called research to support their vaccine skepticism on the Internet, but Marshall does not fault the Google algorithm that feeds parents information that supports their fears. He blames the lack of critical thinking and basic scientific literacy.

“Our culture today is anti-science,” Marshall said.

Outbreaks of measles are popping up across the country in unvaccinated communities that rub shoulders with the rest of society. Those at the greatest and most serious risk are infants and babies too young for vaccinations and those who for medical reasons cannot receive vaccinations.

In this case and many others, individual rights cease at the threshold of violating another’s rights.

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